<!-- InstanceBeginEditable name="body" --> <table width="100%" border="0" cellpadding="0" cellspacing="0"> <tr> <td align="center" valign="top"> <link href="../master.css" rel="stylesheet" type="text/css"> <body leftmargin="0" topmargin="0" marginwidth="0" marginheight="0"> <form action="" method="POST"> <table border="0" cellpadding="3" cellspacing="0"> <tr> <td valign="bottom" nowrap><font class="b1">First Name:</font></td> <td> <input name="firstname" type="text" id="firstname" value="" size="17"> </td> </tr> <tr> <td valign="bottom" nowrap><font class="b1">Last Name:</font></td> <td> <input name="lastname" type="text" id="lastname" value="" size="17"></td> </tr> <tr> <td valign="bottom" nowrap><font class="b1">Phone:</font></td> <td> <input name="phone" type="text" id="phone" value="" size="17"> </td> </tr> <tr> <td valign="bottom" nowrap><font class="b1">Email:</font></td> <td> <input name="email" type="text" id="email2" value="" size="17"></td> </tr> <tr> <td colspan="2" valign="bottom"><font class="b1">Desired Service:</font> <select name="service" id="service"> <option value="Project" selected>Project</option> <option value="Design">Design</option> <option value="Automation">Automation</option> <option value="Layout">Layout</option> </select></td> </tr> <tr> <td height="25" colspan="2" valign="bottom"><font class="b1">Additional Comments:</font></td> </tr> <tr> <td colspan="2" align="center"><textarea name="message" cols="25" rows="4" id="textarea"></textarea> </td> </tr> <tr> <td colspan="2" align="left" class="b1">In the box below, type the code you see in the image. Letters are case sensitive. <br> <img src="/email/antispam.php" /> <input type="text" name="verify" maxlength="6" size="6" /> <input type="submit" name="submit" value="Submit" /> <input name="reset" type="reset" value="Reset" /></td> </tr> </table> </form> </td> <td align="center" valign="top"> <table border="0" cellpadding="0" cellspacing="0"> <tr> <td><p><font class="b1"><h1>Postal Address:</font><br> <font class="b1"> P.O. Box 8093<br> Fort Wayne, IN 46898</font></font></p> <p><h1>Email:</font><font class="b1"><br> <a href="mailto:%69%6e%66%6f%40%6c%65%6d%65%72%74%67%72%6f%75%70%2e%63%6f%6d">info@lemertgroup.com</a> </font></p> <p><h1>Phone:</font><font class="b1"><br> 260-492-4248<br> <br> <h1>Fax:</font><br> <font class="b1"> 775-942-6038</font></font></p></td> </tr> </table></td> </tr> </table> <!-- InstanceEndEditable -->
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